The Three Delays Model has been commonly used to understand and prevent maternal mortality but has not been systematically applied to emergency medical conditions more generally. The objective of this study was to identify delays in emergency medical care seeking and delivery in rural Bangladesh and factors contributing to these delays by using the Three Delays Model as a framework.
A qualitative approach was used. Data were collected through focus group discussions and in-depth interviews using semistructured guides. Two analysts jointly developed a codebook iteratively and conducted a thematic analysis to triangulate results.
Six unions in Raiganj subdistrict of Bangladesh.
Eight focus group discussions with community members (n=59) and eight in-depth interviews with healthcare providers.
Delays in the decision to seek care and timely receipt of care on reaching a health facility were most prominent. The main factors influencing care-seeking decisions included ability to recognise symptoms and dech facilities.Atrial fibrillation (AF) is a heart condition associated with a fivefold increased risk of stroke. The condition can be detected in primary care and treatment can greatly reduce the risk of stroke. In recent years, a number of policy initiatives have tried to improve diagnosis and treatment of AF, including local National Health Service schemes and the Quality and Outcomes Framework. We aimed to examine trends in the incidence of recorded AF in primary care records from English practices between 2004 and 2018.
Longitudinal cohort study.
English primary care electronic health records linked to Index of Multiple Deprivation data.
Cohort of 3.5 million patients over 40 years old registered in general practices in England, contributing 22 million person-years of observation between 2004 and 2018.
Incident AF was identified through newly recorded AF codes in the patients' records. Yearly incidence rates were stratified by gender, age group and a measure of deprivation.
Incidence rates were stable before 2010 and then rose and peaked in 2015 at 5.07 (95% CI 4.94 to 5.20) cases per 1000 person-years. Incidence was higher in males (4.95 (95% CI 4.91 to 4.99) cases per 1000 person-years vs 4.12 (95% CI 4.08 to 4.16) in females) and rises markedly with age (0.58 (95% CI 0.56 to 0.59) cases per 1000 person-years in 40-54 years old vs 21.7 (95% CI 21.4 to 22.0) cases in over 85s). The increase in incidence over time was observed mainly in people over the age of 75, particularly men. There was no evidence that temporal trends in incidence were associated with deprivation.
Changes in clinical practice and policy initiatives since 2004 have been associated with increased rates of diagnosis of AF up until 2015, but rates declined from 2015 to 2018.
Changes in clinical practice and policy initiatives since 2004 have been associated with increased rates of diagnosis of AF up until 2015, but rates declined from 2015 to 2018.Hospital-acquired infections (HAIs) are public health problems of global concern and are notably prevalent in developing countries. The prevalence of HAI and its associated factors are not well described in the context of Ethiopia. Currently, the nationwide prevalence of HAI and its corresponding associated factors have not been formally reported in Ethiopia. This review will provide an estimate of the prevalence of HAI and its associated factors.
Scholarly articles will be selected from the Embase, PubMed, Cochrane library, Hinary, Scopus, Web of Science and Google Scholar databases. Articles within the timeline of January 2000 to December 2020 will be included for review. Observational studies, randomised trials, surveys, surveillance reports, published and grey literature that reported the prevalence of HAI or factors associated with HAI reported as OR (95% CI) with no language restriction will be included in the analysis. https://www.selleckchem.com/products/cx-5461.html Screening and selection of articles will be done using web-based Covidence software. The article's quality and risk of bias will be critically appraised using Johanna Briggs Institute quality appraisal checklist. Random effects model using the inverse variance method will be conducted to estimate the prevalence of HAI. To examine heterogeneity, the Q statistics and Istatistics will be conducted. Publication bias will be investigated using Begg's correlation method and Egger's weighted regression test. All analyses will be performed with STATA (V.14) software.
Ethical approval is not required for meta-analysis reviews as participants are not included. The review will be submitted for publication in peer-reviewed journals.
Ethical approval is not required for meta-analysis reviews as participants are not included. The review will be submitted for publication in peer-reviewed journals.About 2%-30% of cardiac catheterisation procedures get complicated by radial artery occlusion (RAO). Ensuring patent haemostasis appears to be an important factor in reducing RAO. Currently employed method is a radial compression device (RCD) such as transradial band (TRB) that take hours to achieve haemostasis and cause discomfort to the patients. Haemostatic pads offer an alternative to RCD with reduced time to achieve haemostasis. Our trial aims to determine the non-inferiority of the catecholamine chitosan-based pad (InnoSEAL haemostatic pad) used in conjunction with TRB (InnoSEAL +TRB) when compared with the TRB alone in reducing composite adverse access site outcomes.
It will be an open-label, parallel, randomised controlled trial on 714 adult patients (325 in each arm) undergoing coronary procedure using transradial approach at a cardiac health facility over 7?months duration. InnoSEAL patch along with TRB will be used to control bleeding in intervention arm and TRB alone in control arm, which is the standard practice. Study primary outcomes include RAO and haematoma; secondary outcomes are compression time, patient discomfort, time to discharge and ease of use of the intervention technique by the healthcare staff. χtest will be used to compare the categorical outcomes between two arms and student's t-test for continuous outcomes. A p value of &lt;0.05?will be considered significant.
Ethical approval for the study has been obtained from the Institutional Review Board of Tabba Heart Institute number IORG0007863. Findings will be disseminated through seminars and scientific publications.
NCT04380883; Pre-results.
NCT04380883; Pre-results.